APC 5522
Hospitals report these codes with terse, inconsistent chargemaster text. This plain-English title was written by an AI model from that text and has not been reviewed by a person, so it can be wrong. The prices on this page come straight from hospital filings and do not depend on it.
Generation details were not recorded for this description.
Original text from hospital filings
Level 2 Imaging without Contrast
Low
$19
Average
$170
Median
$133
High
$3.2k
Each hospital's average Molina rate, under the methodology and billing class chosen below.
261 hospitals; the 90th percentile is 2.8× the 10th. Each bar is a price range and its height is how many hospitals fall in it. Hover a bar, or a row in the ladder, for details.
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266 hospital rates
iThe hospitals that file a Molina rate for this code, one row per hospital and set of terms (billing class, payment method, setting). Rates under different terms are never blended, so the terms are shown under each hospital’s name. Figures are the hospital’s averages across its plans.| # | Plans | |||||||
|---|---|---|---|---|---|---|---|---|
| 1 | Adventhealth Central Texas Killeen, TX other · outpatient | 1 | $343 | $343 | — | — | 1–10 | $343 – $343 |
| 2 | Adventhealth Manchester Manchester, KY other · outpatient | 1 | $287 | $287 | — | — | 110 | $287 – $287 |
| 3 | Adventhealth Palm Coast Parkway Palm Coast, FL other · outpatient | 1 | $69 | $69 | — | — | 1–10 | $69 – $69 |
| 4 | Agnesian Healthcare Inc. Fond Du Lac, WI other · outpatient | 2 | $78 | $78 | $8 | 10% | 2–20 | $70 – $86 |
| 5 | Aiken Regional Medical Centers North Augusta, SC fee schedule · outpatient | 1 | $110 | $110 | — | — | — | $110 – $110 |
| 6 | Berger Hospital Circleville, OH other · outpatient | 2 | $115 | $115 | $16 | 14% | 263 | $99 – $132 |
| 7 | Bethesda Hospital Inc. Lebanon, OH facility · other · outpatient | 2 | $143 | $143 | $45 | 31% | 220 | $98 – $188 |
| 8 | Brandon HMA LLC Brandon, MS facility · fee schedule · outpatient | 2 | $136 | $136 | $35 | 26% | — | $101 – $171 |
| 9 | Carlsbad Medical Center LLC Carlsbad, NM facility · fee schedule · outpatient | 2 | $206 | $206 | $97 | 47% | — | $109 – $303 |
| 10 | Centennial Hills Las Vegas, NV fee schedule · outpatient | 1 | $106 | $106 | — | — | — | $106 – $106 |
| 11 | Clifton Springs Hospital And Clinic Clifton Springs, NY facility · other · outpatient | 2 | $59 | $59 | $2 | 3% | 2–20 | $57 – $61 |
| 12 | Clinton Memorial Hospital Wilmington, OH other · outpatient | 3 | $110 | $116 | $18 | 15% | 87 | $98 – $141 |
| 13 | Corewell Health Big Rapids Hospital Big Rapids, MI facility · other · outpatient | 3 | $92 | $117 | $61 | 53% | 369 | $57 – $201 |
| 14 | Corewell Health Blodgett Hospital East Grand Rapids, MI facility · other · outpatient | 3 | $86 | $110 | $56 | 51% | 904 | $57 – $188 |
| 15 | Corewell Health Butterworth Hospital Grand Rapids, MI facility · other · outpatient | 3 | $86 | $110 | $56 | 51% | 904 | $57 – $188 |
| 16 | Corewell Health Farmington Hills Hospital Farmington Hills, MI facility · other · outpatient | 3 | $94 | $95 | $32 | 34% | 974 | $57 – $135 |
| 17 | Corewell Health Gerber Hospital Fremont, MI facility · other · outpatient | 1 | $77 | $77 | — | — | 203 | $77 – $77 |
| 18 | Corewell Health Gerber Hospital Fremont, MI facility · percent of total billed charges · outpatientfrom % of charges | 2 | $283 | $283 | $62 | 22% | 156 | $220 – $345 |
| 19 | Corewell Health Greenville Hospital Greenville, MI facility · other · outpatient | 3 | $86 | $110 | $56 | 51% | 386 | $57 – $188 |
| 20 | Corewell Health Ludington Hospital Ludington, MI facility · other · outpatient | 3 | $115 | $124 | $59 | 48% | 185–194 | $57 – $201 |
| 21 | Corewell Health Pennock Hospital Hastings, MI facility · other · outpatient | 1 | $77 | $77 | — | — | 83 | $77 – $77 |
| 22 | Corewell Health Pennock Hospital Hastings, MI facility · percent of total billed charges · outpatientfrom % of charges | 2 | $228 | $228 | $16 | 7% | 25–34 | $213 – $244 |
| 23 | Corewell Health Reed City Hospital Reed City, MI facility · other · outpatient | 1 | $77 | $77 | — | — | 161 | $77 – $77 |
| 24 | Corewell Health Reed City Hospital Reed City, MI facility · percent of total billed charges · outpatientfrom % of charges | 2 | $302 | $302 | $98 | 32% | 99 | $204 – $400 |
| 25 | Corewell Health Zeeland Community Hospital Zeeland, MI facility · other · outpatient | 2 | $122 | $122 | $65 | 53% | 114 | $57 – $188 |
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